Protein-energetic malnutrition as a predictor of mortality in patients on haemodialysis

Abstract

INTRODUCTION: Malnutrition in patients on haemodialysis represents an important factor of mortality. The aim of the study was to estimate the influence and predictive significance of malnutrition on mortality of patients on haemiodialysis. MATERIAL AND METHODS: There were analyzed the outcomes of treatmnent of patients on outpatient program of haemodialysis who were hospitalized in Clinical Centre "Kragujevac" for different reasons. The study included the analysis of demographic characteristics, duration of dialysis, body mass index, indications for hospitalization, result of the treatment and biochemical parameters. RESULTS: 39.2% of the examined patients had the elements of protein-energetic malnutrition; 36.8% of patients with malnutrition died; the difference between the groups was statistically sign,ificant (p = 0.0006) regarding the results of treatment. Statistically significant difference (p < 0.0001) was also obtained concerning the body mass index with its value of 17.1 +/- 1.55 kg/m2 in patients with malnutrition. Cardiovascular diseases were statistically more common in patients with malnuttrition (p = 0.037). In correlation of the group of patients with and the group without malnutrition a statistically significant difference in number of erythrocytes was found (2.87 +/- 0.71 vs. 3.26 +/- 0.5 x 1012; p = 0.04), concentration of hemoglobin (85 +/- 15.7 vs. 104 +/- 15.7; p < 0.0001), level of creatinin (874 +/- 229.3 vs. 998 +/- 237.8 micromol/L: p = 0.04), total proteins (66.5 +/- 5.4 vs. 70 -/+ 4.47 g/L: p = 0.001), albumin (30 +/- 3.7 vs. 38 +/- 4.38: p < 0.0001), total cholesterol (3.05 +/- 1.14 vs. 4.31 +/- 1.2 micromol/L: p < 0.0001), C-reactive protein (9.5 +/- 6.8 vs. 2.9 +/- 5.09 mg/L: p < 0.0001) and concentration of fibrinogen (4.960 +/- 0.91 vs. 4.22 +/- 0.91 micromol/L p = 0.l01). Survival time in patients with malnutrition was statistically shorter--18 months (p < 0.0001). CONCLUSIONS: A third of the examined patients in our study were malnourished with lower survival rate. More than two thirds of patients witih malnutrition died.